Table of Contents
ISRN Gastroenterology
Volume 2012, Article ID 462642, 7 pages
http://dx.doi.org/10.5402/2012/462642
Research Article

Trends in Early Outpatient Drug Therapy in Pediatric Inflammatory Bowel Disease in Finland: A Nationwide Register-Based Study in 1999–2009

1Research Department, The Social Insurance Institution (Kela), 20720 Turku, Finland
2Children's Hospital, Helsinki University Central Hospital, University of Helsinki, P.O. Box 281, 00029 Helsinki, Finland

Received 25 May 2012; Accepted 25 June 2012

Academic Editors: J. M. Pajares, C.-T. Shun, and C. F. Sier

Copyright © 2012 Lauri J. Virta and Kaija-Leena Kolho. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. There are limited data on the changes of treatment strategies of disease-modifying drugs used to treat pediatric inflammatory bowel disease (IBD). Methods. We utilized data from two national registers: the Drug Reimbursement Register for drug costs (for identifying children with IBD) and the Drug Purchase Register (for exposure to drugs), both of which are maintained by the Social Insurance Institution of Finland. The frequencies and trends of drug therapy strategies during the first year of pediatric IBD were evaluated between 1999 and 2009. Results. A total of 481 children diagnosed with IBD were identified. During the first six months, 68% of the patients purchased systemic corticosteroids; these combined with 5-aminosalicylic acid in almost all cases. The use of corticosteroids was stable from the early years compared with the end of the study period. In Crohn's disease, there was a trend towards more active use of azathioprine: the therapy was introduced earlier and proportion of pediatric patients purchasing azathioprine increased by up to 51% ( ๐‘ƒ < 0 . 0 5 ). Conclusions. In pediatric IBD, the majority of patients purchased corticosteroid within the first six months, reflecting moderate-to-severe disease. During recent years in pediatric Crohn's disease, the therapeutic strategies of oral medication have changed towards more active immunosuppression with azathioprine.